Nephrology - FAQs
What is dialysis?
Dialysis is a medical process through which a person's blood is cleansed of the toxins or wastes that kidneys normally remove. It is used when a person's kidneys no longer function optimally. The purpose is to keep the right levels of chemicals, fluids and salts in the body so that body functions normally.
Which doctor should I see if I have if I need Dialysis?
A Nephrologist or a Physician with interest in kidney diseases.
How many types of dialysis are there?
Renal dialysis falls into two main divisions: haemodialysis and peritoneal dialysis.
Hemodialysis cleans and filters your blood using a machine to temporarily remove harmful wastes, extra salt, and extra water from your body. Hemodialysis is most often performed in a dialysis centre but home treatment options are also available.
Peritoneal dialysis uses the lining of your abdomen and dialysis solution (a mixture of minerals and sugar dissolved in water) to filter your blood removing wastes, chemicals and extra water from your body. After several hours, the used solution is drained from your abdomen through a tube and the cycle is repeated with fresh solution
Which type of dialysis is better?
Both are good, choice usually depends on personal lifestyle of the patient and certain medical conditions like congestive heart failure, vascular access complications, diabetes etc. Hemodialysis is usually performed at a dialysis centre as compared to peritoneal dialysis which can be safely done at home .CAPD is usually preferred in children as they have small vessels which are difficult to cannulate and repeated needling is painful and difficult in them. Fluid intake can be more liberal in CAPD.
Why does one put on weight in between hemodialysis?
Putting on weight between dialysis is usual. It is because all food that is consumed by you has some water/ fluid which is not excreted by the diseased kidneys. The amount of weight gain should not be more than 2.5 – 3 kg between two sessions of hemodialysis.
Is it dangerous to skip dialysis?
Yes, this can lead to fluid overload and breathing problem. It can also increase your serum potassium level which can lead to serious cardiac complications. Therefore skipping dialysis can be life threatening.
What is an access?
An access usually refers to a vein or vessel from which blood is taken to the dialysis machine and returned back .It can be a catheter, Arterio venous fistula or an Arterio venous graft.
The access which is usually a fistula, graft, or catheter should be taken care of and one should not wear tight clothing or jewellery on the access arm nor should blood pressure be checked on the arm.
What basic precautions should a patient of dialysis take?
While on dialysis you should watch your diet. In case of any breathing trouble you should contact your doctor as you may require urgent dialysis. Care of the vascular access should be ensured as advised by your physician.
What sort of diet should I take while on dialysis?
A high protein diet should be taken while on dialysis taking care to avoid high potassium food. Most diabetics do not require any anti diabetic medication on dialysis but blood sugars should be monitored regularly (blood sugar between 150 -200 gm/dl is considered desirable).If your sugars are high or low you would need to consult your doctor.
What is to be done in case of any pus discharge from the exit site of the catheter?
It should be brought to the notice of your doctor.
How does dialysis work and how long does it take to complete?
Like healthy kidneys, dialysis keeps your body in balance. It removes waste, salt and extra water, keeps a safe level of certain chemicals in your blood, such as potassium, sodium and bicarbonate and helps to control blood pressure. A session of hemodialysis usually takes 4 hours three times a week whereas peritoneal dialysis is a continuous process.
Can dialysis cure my kidney disease?
No, dialysis does not cure kidney disease. It does the work which the kidneys should be doing.
Do dialysis patients feel normal?
Patients on adequate dialysis can lead a close to normal life.
Can dialysis patients travel?
Yes, they can travel and whenever they need to travel they should make prior arrangements for dialysis to wherever they are travelling.
Is dialysis uncomfortable?
No, most patients are very comfortable on dialysis; they can watch TV or read a book or work on a laptop.